ADHD in Middle School

Health Writer

If the transition between second and third grade seemed like a difficult one for the child with ADHD, the transition between grade school and middle school is even tougher. Not only are the academic challenges harder, but adolescents in middle school are developing more complex social relationships, trying to gain independence and find more and more demands and responsibilities placed on them.

In grade school, students remain in one classroom throughout the day. Books and supplies, such as pens, pencils and papers are kept in a desk. There is one main teacher who teaches the class the majority of subjects. All of that changes once a child reaches middle school. Suddenly, the students move from classroom to classroom, carrying books, pens and pencils with them. There is a different teacher for each subject. Now, students must "transition" several times each day and develop organizational skills to keep track of school work. The skills needed to succeed in middle school are the skills many children with ADHD struggle with.

Because of the additional demands, socially and academically, in middle school, many symptoms of ADHD become more pronounced. One recent study showed ADHD symptoms to increase or worsen and adolescents experiencing more problems at home during the middle school years.

Additionally, during middle school, a child's self image as well as how peers view him or her often center around school performance. If a child succeeds in school, they may be well liked or thought of in a positive way. If a child struggles or fails a class, they are thought of as "stupid." Social relationships change at this age as well. Belonging to a group becomes extremely important and when a child with ADHD feels he or she doesn't fit in, it can be devastating. Parents and teachers can help by teaching social skills, reinforcing manners and practicing conversation skills.

Hyperactivity can begin to lessen during puberty, but may be replaced with a persistent "restless" feeling or constant fidgeting. Symptoms of inattention remain throughout adolescence and adulthood.

Executive function is the ability to plan, prioritize, organize and complete multiple tasks. Recent research shows deficits in executive function in older children and adults with ADHD. Deficits in executive function may be one of the major reasons ADHD continues to cause problems for some people well into adulthood. Some examples of how deficits in executive function can impact an adolescent's life:

  • Planning is required for social events, for completing large projects or research papers, for time management.
  • Being able to complete multiple tasks is needed in order to listen to a teacher speak and take notes.
  • Prioritizing is needed to b able to break down tasks and determine how to best spend time in order to accomplish goals.
  • Organization is needed to manage papers, hand in homework, keep track of books, pencils and other supplies.

In addition to executive function deficits, children with ADHD are often several years below their peers in emotional maturity. While trying to fit in socially with children their own ages, middle school students with ADHD may have the emotional maturity of a fourth or fifth grader. This immaturity may lead to greater turmoil and frustration as well as feelings of isolation.

Emotional maturity also plays a role in the need for independence. As an adolescent with ADHD sees peers begin to be left home alone or be allowed to go to the movies by themselves, they want the same. But the emotional maturity level does not always make this possible. Children's self-esteem can suffer.

When problems relating to ADHD are not addressed, adolescents are more at risk of developing oppositional defiant disorder, conduct disorder or experimenting with drugs and alcohol. Parents need to maintain structure, continue communication with teachers and help prepare adolescents for adulthood by teaching skills and working toward self-sufficiency.

Sources:

"What is ADHD?", 2002, Jim Chandler, M.D., Attention Deficit Disorder Resources

"(ADD) ADHD at Different Ages", Date Unknown, Author Unknown, Edge Foundation

"Attention Deficit Hyperactivity Disorder", 2008, Aug, Kevin Leehey, M.D., LeeheyMD.com

"Attention Deficit Hyperactivity Disorder", 2008, April 3, Author Unknown, National Institute of Mental Health